URINARY OSCE

Question 1

URINALYSIS: Causes of Bilirubin elevations

Answer 1

• biliary obstruction causing elevated serum conj. bil.

Question 2

URINALYSIS: Causes of Ketones elevations

Answer 2

Starvation

DKA

Question 3

URINALYSIS: Changes to specific gravity

Answer 3

LOW = DILUTE

• Diabetes insipidus
• Acute tubular necrosis

HIGH = CONC.

• dehydraton
• glycosuria
• proteinuria = NEPHROTIC

Question 4

URINALYSIS: pH Changes

Answer 4

ACIDIC SHIFT

• starvation
• DKA
• Sepsis

ALKALINE SHIFT

• UTI
• vomiting
• diuretics

Question 5

URINALYSIS: Elevated blood

Answer 5

UTI
Stones
NEPHRITIC SYNDROME

Question 6

URINALYSIS: Protein elevations

Answer 6

NEPHROTIC SYNDROME

Chronic Kidney Disease

Question 7

URINALYSIS: Nitrite Elevations

Answer 7

UTI (gram -ve)

Question 8

URINALYSIS: UROBIILINOGEN changes

Answer 8

(product of bili. breakdown)
ELEVATED = haemolysis

DECREASED = biliary obstruction

Question 9

Hallmarks of Nephrotic Syndromes

Answer 9

Proteinuria therefore HYPOALBUMINEMIA
- frothy appearance

•Oedema

• peripheral
• facial

•hyperlipidaemia
- XANTHELASMA

•hypercoagulability

• MI
• DVT

+fatigue
+ infections (imm dysf.)

Question 10

Hallmarks of Nephritic Syndromes

Answer 10

• haematuria, +mild to moderate proteinuria (typically less than 3.5g/L/day),
• hypertension,
• oliguria
• red cell casts in the urine

Uraemic symptoms (e.g. reduced appetite, fatigue, pruritus, nausea)